Overuse Physeal Injuries in Youth Athletes

Abstract

Context:Despite rising awareness of the risks associated with sports participation, overuse injuries continue to increase in youth athlete populations. Physeal injuries are one type of overuse injury exclusive to pediatric populations that are often sustained during athletic practice or competition. Overuse physeal injuries are, in theory, preventable; however, little consensus has been reached surrounding the risk factors, prevention, and treatment strategies.Objective:This systematic review summarizes the best available evidence concerning overuse physeal injuries in youth and adolescent athletes. It can be used to develop prevention and treatment programs specific to this population.Data Sources:PubMed and Academic Search Complete (EBSCOhost) were explored using the keyword physeal injuries from January 1950 through May 2015 to identify 24 studies.Study Selection:Original research studies of athletic populations with mechanisms of injury related to sport were chosen.Study Design:Systematic review.Level of Evidence:Level 3.Data Extraction:Data were extracted as available from 24 eligible studies. Study quality was rated using the Oxford Centre for Evidence-based Medicine (OCEBM) guidelines.Results:Risk factors for injury include periods of accelerated growth, chronological age, body size, training volume, and previous injury. Injury prevention strategies currently emphasize participation limitations and sport-specific training programs in skeletally immature athletes. The most effective treatment after an overuse physeal injury was an extended period of active rest and joint immobilization when necessary.Conclusion:Overuse physeal injuries are multifactorial in nature. Muscular imbalances after accelerated growth periods predispose young athletes to overuse injuries. Modifiable risk factors such as flexibility, strength, and training volume should be regularly monitored to prevent these injuries.

Unintentional Injuries in Primary and Secondary Schools in the United States, 2001‐2013

“…Likewise, the odds of injury attributable to sports were higher in the school setting compared to nonschool locales. There are several plausible explanations for this finding, such as increased physical fitness in athletes, higher quality equipment, or better trained, more experienced, or more attentive coaches/trainers/supervision in community‐based sports, all of which may lead to fewer serious injuries . Or, it may be the case that school personnel are more likely than other individuals in the community to seek/recommend ED care for injured students (ie, ascertainment bias).…”

“…There are several plausible explanations for this finding, such as increased physical fitness in athletes, higher quality equipment, or better trained, more experienced, or more attentive coaches/trainers/supervision in community-based sports, all of which may lead to fewer serious injuries. [20][21][22][23] Or, it may be the case that school personnel are more likely than other individuals in the community to seek/recommend ED care for injured students (ie, ascertainment bias). We are unable to test these hypotheses using the current dataset and recommend their investigation in future studies.…”

Overuse Injuries in Youth Sports: Legal and Social Responsibility

“…Rapid changes in physical growth make children particularly vulnerable to overuse injuries, and these types of injuries are increasing among youth populations (Arnold, Thigpen, Beattie, Kissenberth, & Shanley, 2017). A recent study examining visits to a sports clinic for youth ages 5 to 17 found that 53% of visits involved overuse injuries (Stracciolini et al, 2014).…”

The long-term impact on self-reported health, function and comorbidities from lower limb apophysitis: Protocol of a cross-sectional study

“…[5][6][7][8][9] For early adolescence, when growth velocity peaks (ages 10-16), 10 the most common growth related injuries is apophysitis in the lower limb; Severs in the heel, and Sinding Larsen Johansson and Osgood Schlatter in the knee. 11 All three entities cause long-term pain, decrease in function, and can reduce or completely hinder participation in sports and physical activity. [12][13][14][15][16][17] The most common, Osgood Schlatter, affects 1 in 5 active adolescents.…”